Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.
Original text from hospital filings
HC Topical Fluoride Varnish Appl
Low
$10
Average
$744
Median
$18
High
$5.8k
Each hospital's average Premera rate, under the methodology and billing class chosen below.
8 hospitals; the 90th percentile is 125.4× the 10th. Each bar is a price range and its height is how many hospitals fall in it. Hover a bar, or a row in the ladder, for details.
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9 hospital rates
iThe hospitals that file a Premera rate for this code, one row per hospital and set of terms (billing class, payment method, setting). Rates under different terms are never blended, so the terms are shown under each hospital’s name. Figures are the hospital’s averages across its plans.| # | Plans | |||||||
|---|---|---|---|---|---|---|---|---|
| 1 | Mercy Health Saint Marys Rockford, MI professional · fee schedule · both | 1 | $19 | $19 | — | — | 1–10 | $19 – $19 |
| 2 | St Mary Mercy Livonia Livonia, MI professional · fee schedule · outpatient | 1 | $19 | $19 | — | — | 1–10 | $19 – $19 |
| 3 | Columbia Lutheran Charities Astoria, OR facility · percent of total billed charges · bothfrom % of charges | 1 | $53 | $53 | — | — | — | $53 – $53 |
| 4 | PORTLAND ADVENTIST MEDICAL CENTER Portland, OR percent of total billed charges · outpatientfrom % of charges | 1 | $18 | $18 | — | — | — | $18 – $18 |
| 5 | Plymouth Medical Center Plymouth, IN facility · other · outpatient | 1 | $5.8k | $5.8k | — | — | — | $5.8k – $5.8k |
| 6 | Public Hospital District NO 2 Skagit County Washington Anacortes, WA facility · fee schedule · both | 1 | $10 | $10 | — | — | — | $10 – $10 |
| 7 | St Josephs Hospital Health Center Syracuse, NY professional · fee schedule · both | 1 | $20 | $20 | — | — | — | $20 – $20 |
| 8 | St Mary Mercy Livonia Livonia, MI professional · fee schedule · inpatient | 1 | $15 | $15 | — | — | — | $15 – $15 |
| 9 | Virginia Mason Medical Center Seattle, WA professional · fee schedule · outpatient | 2 | $16 | $16 | $5 | 34% | — | $10 – $21 |
← Payers reporting CPT 99188 · Snapshot 20261111T120946Z-9134e7f7